LETTERS TO THE EDITOR
|Year : 2023 | Volume
| Issue : 2 | Page : 180-181
Novel Use of VP Shunt Stylet for Difficult Catheterisation in Proximal Hypospadias
Sarda Child Surgery and Child Urology Center, Nagpur, Maharashtra, India
|Date of Submission||10-Dec-2022|
|Date of Decision||02-Jan-2023|
|Date of Acceptance||10-Jan-2023|
|Date of Web Publication||03-Mar-2023|
Sarda Child Surgery and Child Urology Center, Suretech Hospital, Dhantoli, Nagpur - 440 012, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sarda D. Novel Use of VP Shunt Stylet for Difficult Catheterisation in Proximal Hypospadias. J Indian Assoc Pediatr Surg 2023;28:180-1
|How to cite this URL:|
Sarda D. Novel Use of VP Shunt Stylet for Difficult Catheterisation in Proximal Hypospadias. J Indian Assoc Pediatr Surg [serial online] 2023 [cited 2023 Mar 24];28:180-1. Available from: https://www.jiaps.com/text.asp?2023/28/2/180/371168
An enlarged prostatic utricle is a vestigial remnant of the Mullerian duct which is most commonly associated with proximal hypospadias. In proximal hypospadias, it may be difficult to insert the catheter in the bladder as it can enter the enlarged prostatic utricle. Although there is not much written in the literature about how to insert the catheter in such a situation. Although the surgeons are trained to overcome the inadvertent catheterization of the prostatic utricle by different maneuvers such as simultaneous per rectal prostatic pressure to obliterate the prostatic utricle, double catheterization where one feeding tube enters into the utricle and the other enters into the bladder and then removal of a utricle feeding tube or cystoscopic insertion of a catheter. All of them are time-consuming or cumbersome.
The assembly of ventriculoperitoneal (VP) shunt has a metallic stylet which is easily available to most pediatric surgeons. It is semisoft, malleable, and can be easily sterilized by an autoclave. This stylet can be reshaped such as the curvature of the urethra. Then, it can be threaded through one of the side holes of the feeding tube as shown in the [Figure 1]. It is exactly such as the Coude catheter or sound probe used in adults for catheterization. The assembly is atraumatic as the tip of the feeding tube remains blunt and closed. Using generous lubrication, it should be guided through the meatus along the urethral curvature sliding the tip on the anterior wall of the urethra. Usually, it easily slips into the bladder and does not enter into the prostatic utricle which is located on the posterior wall.
|Figure 1: Novel use of VP shunt stylet for easy catheterization in proximal hypospadias. VP: Ventriculoperitoneal|
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We conclude that VP shunt stylet can be used as an easy tool during difficult catheterization in hypospadias with enlarged prostatic utricles.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Manjiri S, Luthra K, Padmalatha SK, Shetty J, Patil N. Symptomatic prostatic utricle: Various approaches for treatment. Ann Pediatr Surg 2020;16:62-8.
Kraft KH, Shukla AR, Canning DA. Proximal hypospadias. Scientific World Journal 2011;11:894-906.